Minority Health Archive

Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study.

Sacco, R L and Boden-Albala, B and Abel, G and Lin, I F and Elkind, M and Hauser, W A and Paik, M C and Shea, S (2001) Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study. Stroke; a journal of cerebral circulation, 32 (8). pp. 1725-1731. ISSN 1524-4628

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Abstract

BACKGROUND AND PURPOSE: Stroke risk factors have been determined in large part through epidemiological studies in white cohorts; as a result, race-ethnic disparities in stroke incidence and mortality rates remained unexplained. The aim in the present study was to compare the prevalence, OR, and etiological fraction (EF) of stroke risk factors among white, blacks, and Caribbean Hispanics living in the same urban community of northern Manhattan. METHODS: In this population-based incident case-control study, cases (n=688) of first ischemic stroke were prospectively matched 1:2 by age, sex, and race-ethnicity with community controls (n=1156). Risk factors were determined through in-person assessment. Conditional logistic regression was used to calculate adjusted ORs in each race-ethnic group. Prevalence and multivariate EFs were determined in each race-ethnic group. RESULTS: Hypertension was an independent risk factor for whites (OR 1.8, EF 25%), blacks (OR 2.0, EF 37%), and Caribbean Hispanics (OR 2.1, EF 32%), but greater prevalence led to elevated EFs among blacks and Caribbean Hispanics. Greater prevalence rates of diabetes increased stroke risk in blacks (OR 1.8, EF 14%) and Caribbean Hispanics (OR 2.1 P<0.05, EF 10%) compared with whites (OR 1.0, EF 0%), whereas atrial fibrillation had a greater prevalence and EF for whites (OR 4.4, EF 20%) compared with blacks (OR 1.7, EF 3%) and Caribbean Hispanics (OR 3.0, EF 2%). Coronary artery disease was most important for whites (OR 1.3, EF 16%), followed by Caribbean Hispanics (OR 1.5, EF 6%) and then blacks (OR 1.1, EF 2%). Prevalence of physical inactivity was greater in Caribbean Hispanics, but an elevated EF was found in all groups. CONCLUSIONS: The prevalence, OR, and EF for stroke risk factors vary by race-ethnicity. These differences are crucial to the etiology of stroke, as well as to the design and implementation of stroke prevention programs.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: data interpretation, statistical, epidemiology, risk factors, stroke
Subjects: Health > Disparities
Health > Public Health > Chronic Illness & Diseases > Cardiovascular Disease
Health > Public Health > Health Risk Factors
Research > studies
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Depositing User: Users 141 not found.
Date Deposited: 02 Aug 2011 13:37
Last Modified: 02 Aug 2011 13:37
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/2973

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